A 28-year-old man repeatedly sets fires in his neighbourhood. He describes mounting tension before the act, intense pleasure and relief during the act, and no financial or ideological motive. The DSM-5 diagnosis is:

• A Antisocial personality disorder
• B Conduct disorder
• C Intermittent explosive disorder
• D Pyromania ✓

Explanation

Pyromania requires: deliberate fire-setting on more than one occasion; tension or affective arousal before the act; fascination, interest, or attraction to fire; pleasure, gratification, or relief when setting fires or witnessing their aftermath; fire-setting not done for monetary gain, to conceal a crime, to express anger, due to a delusion, or due to impaired judgment. The key diagnostic feature distinguishing pyromania from other fire-setting is the specific affective sequence (tension → pleasure/relief) and the absence of external motivation. It is rare and must be distinguished from purposeful or conduct-driven fire-setting.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.